Quasi-Randomized Trial of Effects of Perioperative Oral Hygiene Instruction on Inpatients with Heart Diseases Using a Behavioral Six-Step Method

Abstract

The assessor-blinded, parallel-design, quasi-randomized study (alternating allocation) aimed to determine the effects of the six-step method on postoperative numbers of oral bacteria, periodontal status, and atrial fibrillation (AF) among inpatients with heart diseases and periodontitis. Seventy inpatients who received preoperative periodontal treatment were quasi-randomly assigned to intervention and control groups at University Hospital. The intervention group received intensive oral hygiene instruction using a six-step method for 15 minutes per week and the control group received routine oral hygiene instruction. Significantly fewer oral bacteria were identified on the tongue at discharge compared with baseline in the intervention than the control group (ANCOVA) (large effect size, p = 0.02). Changes in scores for self-efficacy, plaque scores, probed pocket depth, and bleeding on probing between baseline and discharge were significantly greater in the intervention, than in the control group (p < 0.05). The period of postoperative AF (days) was significantly shorter in the intervention, than in the control group (p = 0.019). In conclusion, oral hygiene instruction using the six-step method decreased the numbers of oral bacteria on the tongue and improved self-efficacy, oral health behaviors, oral hygiene status, periodontal status, and period of postoperative AF among inpatients with periodontitis and heart diseases.

Dental and oral management in the perioperative period of surgery: A scoping review

“…There were three SRs, one RCT, and five observational studies [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] , [52] . An SR by Wei et al [44] and Bardia et al [45] examined the incidence of postoperative pneumonia and nosocomial infections between patients who underwent oral rinsing with chlorhexidine and those who underwent rinsing with other drugs or no rinsing.…”

“…The RCT [47] examined the number of postoperative atrial fibrillation days between the intensive oral hygiene and routine oral hygiene groups and reported significantly fewer days in the intensive oral hygiene group (risk of bias; high). In the observational studies, Suzuki et al [51] reported significantly fewer days of postoperative fever-up in heart valve surgery patients who received periodontal therapy before surgery than in those who did not (risk of bias; moderate).…”

“…Regarding other surgical sites, fifteen studies examined the effectiveness of DOM in preventing postoperative SSI and postoperative complications. Eleven of the studies [5] , [18] , [22] , [23] , [24] , [25] , [37] , [40] , [41] , [42] , [47] compared the incidence of SSI between patients with and without preoperative DOM. Eight studies reported that DOM had a significant reduction effect, while three studies [5] , [42] , [46] reported no significant effect.…”

Effects of Oral Inflammatory Diseases and Oral Hygiene on Atrial Fibrillation: A Systematic Review

“…In addition, Omori et al [ 28 ] showed that in hospitalized patients with heart disease complicated with periodontitis, six-step oral hygiene enhancement can improve the occurrence of atrial fibrillation after cardiac surgery. All of the abovementioned studies [ 12 – 14 , 16 , 19 , 28 ] suggested that regular tooth brushing and oral care had an advantage in improving the occurrence and recurrence of atrial fibrillation. Therefore, the importance of long-term tooth brushing and oral hygiene should be emphasized in clinical practice and health promotion.…”

Job Attractiveness and Job Satisfaction of Dental Hygienists: From Japanese Dental Hygienists’ Survey 2019

“…There is a demand for visiting home dental care, oral care for hospitalised patients, and oral health management for older people requiring long-term care. Previous studies have revealed that oral health management of dental hygienists for older adults or hospitalised patients is effective in improving not only oral health, but also general health conditions [ 2 , 3 , 4 ], thus, emphasizing the social role of dental hygienists as professionals in oral health management. However, the employment rate of dental hygienists in Japan is very low compared to other countries [ 5 , 6 ].…”